Dental program aims to offer services in rural communities

Professional groups oppose the effort, saying the work should be done by dentists

Posted: Wednesday, January 17, 2007

By the associated press

ANCHORAGE - A new dental training program that opened on Monday is attempting to expand tooth care services in rural Alaska, where cavity rates far exceed the national average and dentists rarely set up shop.

But state and national dental societies object to the program, saying it allows participants the authority to do work traditionally performed by dentists.

The program's dental therapists, who are health aides with special training, take on the tasks of examining patients, taking X-rays, administering local anesthetics, extracting teeth and filling routine cavities under the long-distance supervision of a dentist.

"We're trying to educate community-oriented health providers - to have a person from the community for the community," said dentist Marco Alberts of the University of Washington. The university launched the program through a $2.8 million grant from the Kellogg Foundation.

The first seven students in the new program started orientation Monday at the Tribal Health Consortium next to the Alaska Native Medical Center.

Students Sheena Nelson, 22, a Tlingit from Yakutat, and Daniel Kennedy, 47, a dental assistant from Klawock, are among the first class of students in the new school. Both said they plan to return to their hometowns to practice.

"I had a bad toothache a couple of years ago," said Nelson, explaining why she signed up. "I didn't get to see anybody for a long time." She said a dentist usually comes to Yakutat every six months.

Students will spend one year in classroom studies at a clinic in Anchorage before taking on clinical work in a rural community. They are required to spend another three months training with a dentist before earning certification as a dental therapist.

Eight dental health therapists trained in New Zealand are already working in rural Alaska and three more are nearly ready.

Aurora Johnson, one of the New Zealand graduates, has been seeing patients in Unalakleet since April, and regularly visits other villages in the western Alaska region.

She does fillings, extractions and exams. And she delivers fluoride treatment to school once a week, and shows children the proper techniques for brushing their teeth.

"They're in pain for such a long period of time," she said, referring to the more remote villages. "When they're no longer in pain they're ever so grateful. This is why I'm here."

The Alaska Dental Society and American Dental Association are attempting to stop people who aren't dentists from drilling or pulling teeth with a lawsuit against the university pending in Anchorage Superior Court. The two sides have been fighting over the issue for more than three years.

The Alaska society supports teaching the aides how to prevent oral diseases, said president-elect Pete Higgins of Fairbanks, but believes such intricate work without the intensive training required by state law puts patients at risk.